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Mary's, 1.16; Cottenham Park, 1.31; South Park, 2.11;
Trinity, 3.03.
The 91 cases occurred in 88 houses, in one of which there
were 5 cases, and iu two others, 2 each.
The cases were spread fairly evenly over the year, the
second aud fourth quarters being somewhat higher; but at no
time was there anything which could be considered in the
nature of an epidemic. In a considerable number diagnosis
was only possible after a swab from the throat or nose had
been taken and a bacteriological examination made. Undoubtedly
the increased number of notifications of late years
is partially accounted for by the extended use of bacteriological
investigations, a proportion which formerly were considered
sore throats or Tonsilitis, now being rightly termed Diphtheria.
This increase in numbers is amply compensated for
by the discovery, through bacteriological examination, of
cases which, if not revealed, would become what is known as
" carriers," that is, whilst the infected persons themselves
enjoy immunity from any ill-effects, they are carrying
unknown in their mucous membrane the organism known to be
typical of Diphtheria, which, under altered conditions in their
own health, or by transmission to other more susceptible persons,
may assume a virulent form.
This mode of the propagation of the disease, which is
only the discovery of recent years, and as to the reality of
which there can be no doubt, suggests new and heretofore unsurmised
hazards, but promises to elucidate some hitherto
obscure and puzzling problems in connection with outbreaks
of Diphtheria and other diseases of microbic origin.
Further, as showing the mildness of a proportion of the
cases, it is not an uncommon occurrence for the recovery certificate
requesting disinfection to be received within fourteen
days from the notification of the illness, but isolation is generally
continued until one or often two bacteriological examinations
give negative results.
These apparently mild cases must not be considered less
important than the severe ones, and from a public health point
of view anything which can insure early discovery and notification
is most important.
It is interesting to note the effects of notification, isolation,
and treatment of the disease since the Notification of
Infectious Diseases Act came into force in January, 1890.
Records of cases in Hospital some few years before that date
are complete, but as we have no available information as to the
total number of persons attacked, the following table only
deals with cases from the adoption of the above Act.
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